Select agents from both classes reduce major adverse cardiovascular events (MACE) and improve kidney outcomes, and SGLT2 inhibitors additionally reduce heart failure (HF) hospitalizations in patients with type 2 diabetes (T2D) with a history of or at high risk for atherosclerotic cardiovascular disease (ASCVD), and there are similar benefits in other populations [1–3]. The gene discussed is SLC5A2; the disease is hydrops fetalis.